Key result
Carotid artery stenting in a real-world Japanese population achieved a 99.5% technical success rate with a 30-day clinically significant complication rate of 2.3%, while the use of closed-cell stents was associated with a reduced risk of complications (OR 0.53).
Why the study?
The study aimed to clarify the outcomes of carotid artery stenting in the Japanese population.
Observational (n=8,458)
Yes
Real-world registry data from Japan demonstrates that carotid artery stenting has a high technical success rate (99.5%) and low complication rate (2.3%), with closed-cell stents offering a safer profile.
Answers are grounded in this paper and cite their sources.
Reassures on CAS safety in Japanese real-world practice; extends prior JR-NET cohorts while highlighting non-modifiable lesion risks.
We aimed to clarify the outcomes of carotid artery stenting (CAS) in the Japanese population. For this purpose, we reviewed data from the Japanese Registry of NeuroEndovascular Therapy 3 (JR-NET3), a retrospective, nation-wide, multi-center, observational study of neuroendovascular treatments in Japan. Of the 9207 patients who underwent CAS between January 2010 and December 2014, 8458 satisfied the inclusion criteria for our analysis. The outcome statistics of this JR-NET3 cohort were compared to those of JR-NET1 and 2 cohorts fitting the same inclusion criteria. Of the 8458 JR-NET3 patients analyzed, 8042 (95.1%) were treated by surgeons with board certification from the Japanese Society for NeuroEndovascular Therapy. Technical success was achieved in 8417 patients (99.5%), whereas 198 patients (2.3%) had clinically significant complications (CSCs). These findings mirrored those obtained for the JR-NET1 and 2 cohorts. On multivariate analysis, risk factors for CAS-associated CSC included symptomatic lesion [odds ratio (OR), 1.91; 95% confidence interval (CI), 1.23-3.00; P = 0.003] and hypoechoic lesion on carotid artery ultrasound (OR, 1.85; 95% CI, 1.21-2.84; P = 0.005), whereas use of closed-cell stents was a predictor of better outcome (OR, 0.53; 95% CI, 0.35-0.79; P = 0.002). The findings of JR-NET3 reflect good outcomes of CAS, but non-modifiable risk factors reflecting lesion characteristics remain of concern. Using closed-cell stents is advisable. Technological advances such as the introduction of new materials may help further improve CAS outcomes in Japanese patients.
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Tokuda et al. (2019) conducted an observational in Carotid artery stenosis (n=8,458). Carotid artery stenting was evaluated on Clinically significant complications (CSCs) at 30 days. Carotid artery stenting in a real-world Japanese population achieved a 99.5% technical success rate with a 30-day clinically significant complication rate of 2.3%, while the use of closed-cell stents was associated with a reduced risk of complications (OR 0.53).
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